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Effect of Immunonutrition on Surgery Outcomes in Cancer Patients: Evidence From an Umbrella Review on Interventional and Observational Meta-Analyses Publisher Pubmed



Mardani H ; Riazi Khameneh U ; Jafari A ; Dolati S ; Baziar N ; Amirpour M ; Zamanian G ; Zamani O ; Zavareh M A T ; Akbari M E ; Akbari A ; Alamdari N M ; Javid Z ; Rahmani J Show All Authors
Authors
  1. Mardani H
  2. Riazi Khameneh U
  3. Jafari A
  4. Dolati S
  5. Baziar N
  6. Amirpour M
  7. Zamanian G
  8. Zamani O
  9. Zavareh M A T
  10. Akbari M E
  11. Akbari A
  12. Alamdari N M
  13. Javid Z
  14. Rahmani J
  15. Ardehali S H
  16. Shadnoush M

Source: BMC Cancer Published:2026


Abstract

Background: Malnutrition is highly prevalent in cancer patients, leading to increased post-surgical complications. This umbrella review of meta-analyses aims to investigate the effect of immunonutrition on surgery outcomes in Cancer patients. Methods: MEDLINE/PubMed, SCOPUS, and WOS databases were investigated from their inception until Sep 2025. Meta-analysis investigating the impact of immunonutrition (or its components) on overall complications, infectious complications, non-infectious complications, mortality, surgical-site infections, anastomotic leak, and length of hospital stay in patients with cancer. Pooled effect sizes and CIs were calculated using a random-effects model. Results: Fifty-four studies were included in the umbrella review. The pooled results showed RR = 0.79; 95%CI: 0.70–0.88; I2 = 39.5% for postoperative overall complications, RR = 0.61; 95%CI: 0.58–0.65; I2 = 47.3% for infectious complications, RR = 0.88; 95%CI: 0.82–0.94; I2 = 0% for non-infectious complications, HR = 0.86; 95%CI: 0.74–0.99; I2 = 0% for mortality, RR = 0.66; 95%CI: 0.59–0.74; I2 = 6.5% for surgical-site infection, RR = 0.69; 95%CI: 0.62–0.77; I2 = 0% for anastomotic leak, and WMD=-1.75 days; 95%CI: -2.09,-1.41; I2 = 90.3% for length of hospital stay in immunonutrition intervention compared to control groups. Subgroup analysis by time of intervention showed that postoperative intervention is more effective in reducing overall complications (RR = 0.69; 95%CI:0.54–0.89) and the length of hospital stay (2.26 days, P = 0.001) compared to preoperative or perioperative intervention. Conclusion: Cancer patients undergoing surgery may benefit from immunonutrition. Postoperative intervention is more effective than pre-or perioperative intervention. © The Author(s) 2026.
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